title: The contemporary practice of psychiatric surgery: results from a global survey of functional neurosurgeons.
abstract: BACKGROUND
  Interest in neurosurgery for psychiatric diseases (NPD) has grown globally. We previously reported the results of a survey of North American functional neurosurgeons that evaluated general attitudes towards NPD and the future directions of the field.
  
  
  OBJECTIVE
  The purpose of this study was to expand on our previous work and obtain a snapshot in time of global attitudes towards NPD among practicing functional neurosurgeons. We measure general and regional trends in functional neurosurgery and focus specifically on surgery for mind and mood, while exploring the future prospects of the field.
  
  
  METHODS
  We designed an online survey and distributed it electronically to 881 members of the following international organizations: World Society for Stereotactic and Functional Neurosurgery, European Society for Stereotactic and Functional Neurosurgery, Asian-Australasian Society for Stereotactic Functional Neurosurgery and the South and Latin American Society for Stereotactic and Functional Neurosurgery. Subsequent statistical and thematic analysis was performed on the data obtained.
  
  
  RESULTS
  Of 881 surveys distributed, 106 were returned (12.8%). Eighty-two percent of functional neurosurgeon respondents were fellowship trained, with movement disorders and pain making up the majority of their practice. Psychiatric indications are the most frequently treated conditions for 34% of survey respondents, and over half of participants (51%) perform epilepsy surgery. Of the psychiatric conditions, obsessive-compulsive disorder and depression are the most common disorders treated. The majority of respondents (90%) felt optimistic about the future of NPD. Two thirds cited the reluctance of psychiatrists to refer patients as the greatest obstacle facing the field, and a majority reported that a cultural stigma surrounding psychiatric diseases exists in their community. In response to hypothetical situations involving cognitive and personality enhancement, opinions varied, but the majority opposed enhancement interventions. Regional variations were examined as well and uncovered distinct attitudinal differences depending on geographic location.
  
  
  CONCLUSIONS
  Surgery for psychiatric conditions is an expanding field within functional neurosurgery. The opinions of international functional neurosurgeons were largely in line with those of their North American colleagues. Optimism regarding the future of NPD predominates, and future editions of this survey can be used to track the evolution of neurosurgeons' attitudes towards NPD and neuroenhancement.
authors.affiliation: Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, B.C., Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mendelsohn
authors.forename: Nir
authors.initials: N
authors.lastname: Lipsman
authors.forename: Andres M
authors.initials: AM
authors.lastname: Lozano
authors.forename: Takaomi
authors.initials: T
authors.lastname: Taira
authors.forename: Mark
authors.initials: M
authors.lastname: Bernstein
mesh_terms: D000349:Africa; D000569:Americas; D001208:Asia; D001291:Attitude of Health Personnel; D044362:Australasia; D024803:Biomedical Enhancement; D046690:Deep Brain Stimulation / Q000523:psychology / Q000706:statistics & numerical data / Q000639:trends; D004827:Epilepsy / Q000601:surgery; D005060:Europe; D005257:Fellowships and Scholarships / Q000706:statistics & numerical data; D005544:Forecasting; D019538:Health Care Surveys; D006801:Humans; D001523:Mental Disorders / Q000601:surgery; D009493:Neurosurgery / Q000193:education / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011364:Professional Practice / Q000706:statistics & numerical data; D011612:Psychosurgery / Q000523:psychology / Q000706:statistics & numerical data* / Q000639:trends; D012955:Societies, Medical